During the past four weeks, how much have you been bothered by the following symptoms?
Symptom	Not at all	A little	A lot
Back pain	0	1	2
Chest pain	0	1	2
Constipation, loose bowels, or diarrhea	0	1	2
Dizziness	0	1	2
Fainting	0	1	2
Feeling tired or having low energy	0	1	2
Feeling your heart pound or race	0	1	2
Headaches	0	1	2
Menstrual cramps or other problems with your periods (women only)	0	1	2
Nausea, gas, or indigestion	0	1	2
Pain in your arms, legs, or joints	0	1	2
Pain or problems during sexual intercourse	0	1	2
Shortness of breath	0	1	2
Stomach pain	0	1	2
Trouble sleeping	0	1	2
Score:	______